Economic Imperative

"Medicaid expenditures will exceed public education expenditures for the first time this year," said Leavitt. "If health care begins to push out all other priorities, it throws off the economic equation."

That's a troubling development for governors and mayors whose states and communities compete for prosperity in a global economy. It's also an opportunity for the IT community to do some genuine good -- but only if a wide range of government officials, health-care providers, health insurers and others can agree on interoperability standards for health-care information and IT systems.

Electronic health records and other IT applications could slash the cost of delivering health care, which has ballooned from an annual cost of $143 per person in 1960 to nearly $6,000 per person today. As with most forms of technology, however, the potential benefits of health IT depend largely on policies that allow these systems to talk to each other.

That's not happening in the widely fragmented health-care industry, according to Leavitt. "I see technology being harnessed in fascinating ways as I visit different communities -- but none of it connects."

Forging those connections is an economic imperative. A week or two after Leavitt addressed NASCIO, the House Education and Workforce Committee heard testimony from education and business leaders on growing foreign competition in math- and science-related fields that threatens traditional U.S. dominance in technology and innovation.

Sure, throwing more money at U.S. schools doesn't automatically mean they'll turn out more scientists and engineers, but allowing the health-care bureaucracy to chew through more cash than the country spends on education is unacceptable.

As the source of payment for nearly half of the nation's health-care expenses, government can drive adoption of interoperable electronic health records and other money-saving solutions.

In his NASCIO keynote, Leavitt called for state officials to work jointly with the federal government to develop standards for health IT and quickly implement them.

Leavitt, former governor of Utah, understands that a collaborative approach stands a better chance of success than one dictated by Washington. Yet he also recognizes the urgency of using technology to help bring health-care costs under control.

"We intend to be highly collaborative on this," Leavitt said. "But make no mistake, we'll do it with a 'forced march' mentality, and I intend to lead the way."

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